• Korean Journal of Veterinary Research
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• v.60 no.2
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• pp.101-104
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• 2020

A 7-year-old female mixed-breed dog was presented to a veterinary clinic for pyometra. During abdominal ultrasonography, an abnormal finding was noted in the gallbladder. A cholecystectomy was performed. Grossly, the gallbladder wall was thickened with a polypoid nodular projection into the lumen. Microscopically, the polyp consisted of a solid sheet of round to polygonal-shaped cells that formed small packets with fibrovascular septa. The neoplastic cells contained abundant cytoplasmic eosinophilic granules. Immunohistochemically, the neoplastic cells were positive to chromogranin A and neuron-specific enolase, whereas they were negative to vimentin and cytokeratin. This case was diagnosed as a primary gallbladder carcinoid tumor.

• Journal of Trauma and Injury
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• v.34 no.4
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• pp.294-298
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• 2021

Extrahepatic biliary tract and gallbladder injuries following blunt abdominal trauma are uncommon. Traumatic cystic duct transection is even rarer, which has frequently caused missed diagnosis and delayed treatment. An 18-year-old female patient with no past medical history was transferred to the Trauma Center of Kyungpook National University Hospital after falling from a height of approximately 20 meters. She became hemodynamically stable after initial resuscitation, and initial contrast-enhanced abdominal computed tomography (CT) showed right kidney traumatic infarction and multiple intrahepatic contusions with minimal fluid collection but no extravasation of the contrast. She was admitted to the intensive care unit. On the second day of hospitalization, her abdomen became distended, with follow-up CT showing a large collection of intra-abdominal fluid. Laparoscopic exploration was then performed, which revealed devascularization of the gallbladder with complete transection of the cystic duct and artery. Laparoscopic cholecystectomy was performed, as well as primary closure of the cystic duct orifice on the common bile duct using a 4-0 Prolene suture. After surgery, no clinical evidence of biliary leakage or common bile duct stricture was observed.

• Journal of Digestive Cancer Research
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• v.5 no.1
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• pp.37-43
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• 2017

Laparoscopic cholecystectomy is of one the most common general surgical operations performed today. Concomitant choledocholithiasis occurs in roughly 10-20% of patients with symptomatic gallstones. Laparoscopic bile duct exploration (LBDE) offers a single-stage minimally-invasive solution to the management of choledocholithiasis. LBDE may be performed either via the transcystic route or via laparoscopic choledochotomy. A number of strategies to improve success are available to the surgeon to help in the problem of complicated choledocholithiasis, these range from simple maneuvers to the use of laser or mechanical lithotriptors. With the advances in laparoscopic surgery, it is also possible to handle complex surgical conditions such as Mirizzi syndrome or recurrent pyogenic cholangitis laparoscopically, even though these have yet to be accepted as standard of care. Following laparoscopic choledochotomy, options for closure include: primary closure, closure over a T-tube, and closure over an endobiliary stent. T-tube placement has been associated with increased operating time and hospital length of stay compared to primary closure, with no significant differences in morbidity. Based on the available literature, LBDE appears comparable to ERCP with regards to procedural efficacy and morbidity. LBDE remains relevant to the general surgeon and is best viewed as being complementary to endoscopic therapy in the management of choledocholithiasis.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.1
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• pp.7-14
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• 2009

Bile juice prevents deposition of cholesterol in the blood vessel, digests fat, and absorbs fatty acid and vitamins, and it plays a great role on metabolism. Recently, emotional stimulus and mentally over-depression cause a person to come to illness, and westernization of way of life makes more patients with cholelithiasis, resulting into without bile secretion after cholelithotomy. Ageing, and gastrectomy and kidney transplantation are also the causes of more cholelithiasis occurrences. To solve these medical problems, we studied how Fel Sus Scrofa, which is not different from human bile juice, was used in the traditional Korean medicine. We I researched flavor, property, efficacy of Fel Sus Scrofa and how it was used by folk medicine, and we studied the usage examples of Fel Sus Scrofa in Sanghanlon and Dongeuibogam. The property of Sus Scrofa is bitter and cold. Its efficacy is to deposit glycogen. So it is known that it has been widely used, with many edible forms, without any humoral loss, for the inflammatory disease from various fever, problems of urine and feces, cutaneous disease, pulmonary disease, opthalmopathy, fever, thirst from diabetes, hepatocystic duct disorder. Fel Sus Scrofa can be used internally and externally to prevent humoral loss, and to control cutaneous disease among various pediatric disorder full of fever. And as we have in mind that it also can be used to treat patients with cholestasis after cholecystectomy, it is expected that post study of it must be done.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.17 no.2
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• pp.98-103
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• 2014

Purpose: Gallbladder (GB) wall thickening can be found in various conditions unrelated to intrinsic GB disease. We investigated the predisposing etiologies and the outcome of acalculous GB wall thickening in children. Methods: We retrospectively analyzed 67 children with acalculous GB wall thickening who had visited our institute from June 2010 to June 2013. GB wall thickening was defined as a GB wall diameter > 3.5 mm on abdominal ultrasound examination or computed tomography. Underlying diseases associated with GB wall thickening, treatment, and outcomes were studied. Results: There were 36 boys and 31 girls (mean age, $8.5{\pm}4.8years$ [range, 7 months-16 years]). Systemic infection in 24 patients (35.8%), acute hepatitis in 18 (26.9%), systemic disease in 11 (16.4%), hemophagocytic lymphohistiocytosis in 4 (6.0%), acute pancreatitis in 3 (4.5%), and specific liver disease in 3 (4.5%) predisposed patients to GB wall thickening. Systemic infections were caused by bacteria in 10 patients (41.7%), viruses in 5 patients (20.8%), and fungi in 2 patients (8.3%). Systemic diseases observed were systemic lupus erythematosus in 2, drug-induced hypersensitivity in 2, congestive heart failure in 2, renal disorder in 2. Sixty-one patients (91.0%) received symptomatic treatments or treatment for underlying diseases. Five patients (7.5%) died from underlying diseases. Cholecystectomy was performed in 3 patients during treatment of the underlying disease. Conclusion: A wide range of extracholecystic conditions cause diffuse GB wall thickening that resolves spontaneously or with treatment of underlying diseases. Surgical treatments should be avoided if there are no definite clinical manifestations of cholecystitis.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5613-5617
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• 2012

Gallbladder carcinoma (GBC) is the commonest cancer of the biliary tree and the most frequent cause of death from biliary malignancies. The incidence of GBC shows prominent geographic, age, race, and gender-related differences and is 4-7 times higher in patients with gallstones. This prompted us to study the clinicopathological aspects of the disease and the incidence of gallstones in gallbladder carcinoma patients, in this part of India. In this, combined retrospective (Jan 2004-March 2010) and prospective study (April 2010-Dec 2011) of eight years, 198 patients of gallbladder carcinoma (50 males and 148 females), (range 28-82 years; mean 55 years) were studied. Most of the patients were poor and presented with abdominal pain and mass, with abnormal lab parameters. Gallstones were present in 86% of patients. Surgical exploration was performed in 130, with gallbladder resection in 60 (including 7 incidental GBC). Adenocarcinoma (87.7%) was the commonest histological type. The study indicates that GBC is common in our scenario. It is a disease of elderly females, has a strong association with gallstones and every cholecystectomy specimen should be examined histopathologically.

• Journal of Gastric Cancer
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• v.12 no.3
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• pp.173-178
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• 2012

Purpose: To report the initial clinical experience with single-incision laparoscopic gastric wedge resection for submucosal tumors. Materials and Methods: The medical records of 10 patients who underwent single-incision laparoscopic gastric wedge resection between July 2009 and March 2011 were reviewed retrospectively. The demographic data, clinicopathologic and surgical outcomes were assessed. Results: The mean tumor size was 2.5 cm (range, 1.2~5.0 cm), and the tumors were mostly located on the anterior wall (4/10) or along the greater curvature (4/10), of the stomach. Nine of ten procedures were performed successfully, without the use of additional trocars, or conversion to laparotomy. One patient underwent conversion to multiport laparoscopic surgery, to get simultaneous cholecystectomy safely. The mean operating time was 66.5 minutes (range, 24~132 minutes), and the mean postoperative hospital stay was 5 days (range, 4~7 days). No serious perioperative complications were observed. Of the 10 submucosal tumors, the final pathologic report revealed 5 gastrointestinal stromal tumors, 4 schwannomas, and 1 heterotopic pancreas. Conclusions: Single-incision laparoscopic gastric wedge resection for gastric submucosal tumors is feasible and safe, when performed by experienced laparoscopic surgeons. This technique provides favorable cosmetic results, and also short hospital stay and low morbidity, in carefully selected candidates.

• Journal of Veterinary Clinics
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• v.23 no.3
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• pp.325-328
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• 2006

A 10-year-old intact female Miniature Schnauzer dog was referred with the primary complaint of persistent anorexia, remittent fever, vomiting and abdominal pain. Hemogram suggested a chronic inflammatory disease. Serum biochemistry showed moderate hepatobiliary cellular damage with severe cholestasis. Abdominal radiography and ultrasonography revealed hepatomegaly, choleliths and sludges in gall bladder and small stones in urinary bladder. Based on diagnostic findings, the case was diagnosed as cholelithiasis complicated with biliary sludge and urolithiais. Using cholecystectomy and cystectomy, choleliths and uroliths were removed from gall bladder and urinary bladder, respectively. The clinical condition was dramatically improved after surgery.

• Journal of the Korea Convergence Society
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• v.11 no.10
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• pp.349-353
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• 2020

Background: The dosage of the anesthetic drugs is generally determined by the total body weight of the patients. However, the drugs can be overdosed when the patient is morbidly obese. We have determined anesthetic induction dose based on lean body mass estimated from bioelectrical impedance analysis (BIA). Case: We report a case of morbidly obese patient (161 cm, 138 kg and body mass index 53.1) who had an elective laparoscopic cholecystectomy. The dose of induction agent was determined by lean body mass estimated by BIA, and the sedation was assessed by the observer's assessment alertness/sedation scale. Conclusions: Dose determination through lean body mass measured by BIA is useful in highly obese patients.

• Clinical and Experimental Pediatrics
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• v.48 no.1
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• pp.104-107
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• 2005

Choledochal cyst is considered to be congenital anomalies of the biliary tract, characterized by varying degrees of cystic dilatation at various segments of the biliary tract. A 20-month-old girl was admitted to Eul-Ji general hospital because of abdominal distension. Physical examination revealed marked splenomegaly and hepatomegaly with nodular surface and hard consistency. Laboratory examination showed elevated transaminase level, alkaline phosphatase level and gamma glutamyltranspeptidase level without evidence of cholestasis. Diagnostic imaging study revealed choledochal cyst with Todani classification type 1. Cholecystectomy and Roux-en-Y choledochojejunostomy was performed, and wedge liver biopsy showed diffuse periportal fibrosis with cirrhotic change and ductular proliferation in the portal area. After operation, hepatosplenomegaly and abnormal laboratory examinations improved rapidly, and in 9 months, the liver and spleen became not palpable. We experienced a case of choledochal cyst complicated by liver cirrhosis on pathology in a 20 month-old girl, and removal of choledochal cyst improved clinical manifestations rapidly.